[Congressional Bills 113th Congress]
[From the U.S. Government Publishing Office]
[H.R. 2480 Introduced in House (IH)]

113th CONGRESS
  1st Session
                                H. R. 2480

 To direct the Secretary of Labor to issue an occupational safety and 
 health standard to reduce injuries to patients, nurses, and all other 
health care workers by establishing a safe patient handling, mobility, 
        and injury prevention standard, and for other purposes.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                             June 25, 2013

     Mr. Conyers (for himself and Mr. George Miller of California) 
 introduced the following bill; which was referred to the Committee on 
   Education and the Workforce, and in addition to the Committees on 
Energy and Commerce and Ways and Means, for a period to be subsequently 
   determined by the Speaker, in each case for consideration of such 
 provisions as fall within the jurisdiction of the committee concerned

_______________________________________________________________________

                                 A BILL


 
 To direct the Secretary of Labor to issue an occupational safety and 
 health standard to reduce injuries to patients, nurses, and all other 
health care workers by establishing a safe patient handling, mobility, 
        and injury prevention standard, and for other purposes.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE; FINDINGS; TABLE OF CONTENTS.

    (a) Short Title.--This Act may be cited as the ``Nurse and Health 
Care Worker Protection Act of 2013''.
    (b) Findings.--Congress finds the following:
            (1) In 2011, registered nurses ranked fifth among all 
        occupations for the number of cases of musculoskeletal 
        disorders resulting in days away from work, with 11,880 total 
        cases. In 2011, nursing assistants reported 25,010 cases--the 
        highest of all occupations. The leading cause of these health 
        care employees' injuries is patient lifting, transferring, and 
        repositioning injuries, which constitute a significant risk to 
        the health and welfare of those employees.
            (2) The physical demands of the nursing profession lead 
        many nurses to leave the profession. Fifty-two percent of 
        nurses complain of chronic back pain and 38 percent suffer from 
        pain severe enough to require leave from work. Many nurses and 
        other health care workers suffering back injury do not return 
        to work. These consequences constitute a material impairment of 
        health for these employees.
            (3) Patients are not at optimum levels of safety while 
        being lifted, transferred, or repositioned manually. Mechanical 
        and other appropriate lift programs can substantially reduce 
        skin tears and pressure ulcers suffered by patients and the 
        frequency of patients being dropped, thus allowing patients a 
        safer means to progress through their care.
            (4) The development of assistive patient handling 
        technology, equipment, and devices has essentially rendered the 
        act of strict manual patient handling outdated and typically 
        unnecessary as a function of nursing care.
            (5) A growing number of health care facilities that have 
        incorporated patient handling technology and practices have 
        reported positive results. Injuries among nursing staff and 
        health care workers have dramatically declined at health care 
        facilities implementing safe patient handling technology, 
        equipment, devices, and practices. As a result, the number of 
        lost work days due to injury and staff turnover has declined. 
        Studies have also shown that assistive patient handling 
        technology successfully reduces workers' compensation costs for 
        musculoskeletal disorders.
            (6) A number of States have implemented safe patient 
        handling, mobility and injury prevention standards. The success 
        of these programs at the facility and State level demonstrates 
        the feasibility of such standards.
            (7) Establishing a safe patient handling, mobility, and 
        injury prevention standard for direct-care registered nurses 
        and other health care workers is a critical component 
        reasonably necessary for protecting the health and safety of 
        nurses and other health care workers, addressing the nursing 
        shortage, and increasing patient safety.
    (c) Table of Contents.--The table of contents of this Act is as 
follows:

Sec. 1. Short title; findings; table of contents.
Sec. 2. Safe patient handling, mobility, and injury prevention 
                            standard.
Sec. 3. Application of safe patient handling, mobility, and injury 
                            prevention standard to facilities receiving 
                            Medicare and Medicaid funds.
Sec. 4. Nonpreemption.
Sec. 5. Definitions.

SEC. 2. SAFE PATIENT HANDLING, MOBILITY, AND INJURY PREVENTION 
              STANDARD.

    (a) Rulemaking.--Notwithstanding any other provision of law, not 
later than 1 year after the date of enactment of this Act, the 
Secretary of Labor shall, pursuant to section 6 of the Occupational 
Safety and Health Act of 1970 (29 U.S.C. 655), promulgate an interim 
final standard on safe patient handling, mobility, and injury 
prevention (in this section such standard is referred to as the ``safe 
patient handling, mobility, and injury prevention standard'') to 
prevent musculoskeletal disorders for direct-care registered nurses and 
all other health care workers handling patients. A final safe patient 
handling, mobility, and injury prevention standard shall be promulgated 
not later than 2 years after the date of enactment of this Act.
    (b) Requirements.--The safe patient handling, mobility, and injury 
prevention standard shall require the use of engineering and safety 
controls to perform handling of patients and the elimination of 
injuries from manual handling of patients by direct-care registered 
nurses and all other health care workers, through the development of a 
comprehensive program, to include the use of mechanical technology and 
devices to the greatest degree feasible. Where the use of mechanical 
technology and devices is not feasible, the standards shall require the 
use of alternative controls and measures, including trained, designated 
lift teams, to minimize the risk of injury to nurses and health care 
workers resulting from the manual handling of patients. The standard 
shall apply to all health care employers, shall generally align with 
interprofessional national safe patient handling, mobility, and injury 
prevention standards, and shall include the following:
            (1) Program development.--A requirement that each health 
        care employer shall develop and implement a safe patient 
        handling, mobility, and injury prevention program within 6 
        months of the date of promulgation of the final standard, which 
        program shall include hazard identification, risk assessments, 
        and control measures in relation to patient care duties and 
        patient handling.
            (2) Technology and equipment purchase and management.--A 
        requirement that, within 2 years of the date of promulgation of 
        the final standard, each health care employer shall purchase, 
        use, maintain, and make accessible to health care workers, such 
        safe patient handling equipment, technology, and accessories as 
        the Secretary determines appropriate.
            (3) Health care worker participation.--A requirement that 
        each health care employer shall obtain input from health care 
        workers, to include direct care registered nurses, health care 
        workers, their representatives, and their collective bargaining 
        agents, in developing and implementing the safe patient 
        handling, mobility, and injury prevention program, including 
        the purchase of technology and equipment and necessary 
        accessories.
            (4) Data tracking and review.--A requirement that each 
        health care employer shall establish a review program to 
        analyze data relevant to the implementation of the employers' 
        safe patient handling, mobility, and injury prevention program, 
        and shall account for circumstances where safe patient handling 
        technology and equipment, or trained, designated lift teams, 
        were not utilized in accordance with the health care employers 
        safe patient handling, mobility, and injury prevention 
        standard. Each health care employer shall upon request, make 
        available their findings and data used in such review, to 
        health care workers, their representatives, their collective 
        bargaining agents, and the Secretary or other Federal agency.
            (5) Incorporation of technology into facilities.--A 
        requirement that each health care employer shall consider the 
        feasibility of incorporating safe patient handling technology 
        as part of process of new facility design and construction, or 
        facility remodeling.
            (6) Education and training.--A requirement that each health 
        care employer shall train health care workers on safe patient 
        handling, mobility, and injury prevention policies, technology, 
        equipment, and devices, initially, and on a continuing annual 
        basis, and as necessary. Such training shall prepare health 
        care workers, including designated lift teams, to identify, 
        assess, and control musculoskeletal hazards of a general 
        nature, and those specific to particular patient care areas, 
        and shall be conducted by an individual with knowledge in the 
        subject matter, and delivered, at least in part, in an 
        interactive simulated point-of-care training and hands-on 
        format that reflects the specific demands of a health care 
        workers' duties.
            (7) Notice of safe patient handling and rights under this 
        act.--A requirement that each health care employer shall post a 
        uniform notice in a form specified by the Secretary that--
                    (A) explains the safe patient handling, mobility, 
                and injury prevention standard;
                    (B) includes information regarding safe patient 
                handling, mobility, and injury prevention policies and 
                training;
                    (C) explains procedures to report patient handling-
                related injuries; and
                    (D) explains health care workers' rights under this 
                Act.
            (8) Annual evaluation.--A requirement that each health care 
        employer shall conduct an annual written evaluation of the 
        implementation of the safe patient handling, mobility, and 
        injury prevention program, including handling procedures, 
        selection of technology, equipment, and engineering controls, 
        assessment of injuries, and new safe patient handling, 
        mobility, and injury prevention technology and devices that 
        have been developed. The evaluation shall be conducted with the 
        involvement of nurses, other health care workers, their 
        representatives, and their collective bargaining agents, and 
        their input shall be documented in the evaluation. Health care 
        employers shall take corrective action as recommended in the 
        written evaluation.
            (9) Right to refuse unsafe assignment.--A requirement that 
        each health care employer shall provide procedures under which 
        a health care worker or employee may refuse to perform the 
        employee's duties if the employee has a reasonable apprehension 
        that performing such duties would violate the safe patient 
        handling, mobility, and injury prevention standard, and would 
        result in injury or impairment of health to the health care 
        worker, other health care workers, or patients. Where 
        practicable, the health care worker must have communicated the 
        health or safety concern to the health care employer and have 
        not been able to obtain a correction of the violation.
    (c) Inspections.--The Secretary of Labor shall conduct unscheduled 
inspections under section 8 of the Occupational Safety and Health Act 
of 1970 (29 U.S.C. 657) to ensure implementation of and compliance with 
the safe patient handling, mobility, and injury prevention standard.

SEC. 3. APPLICATION OF SAFE PATIENT HANDLING, MOBILITY, AND INJURY 
              PREVENTION STANDARD TO FACILITIES RECEIVING MEDICARE AND 
              MEDICAID FUNDS.

    (a) In General.--Section 1866 of the Social Security Act (42 U.S.C. 
1395cc) is amended--
            (1) in subsection (a)(1)(V), by inserting ``and safe 
        patient handling, mobility, and injury prevention standard (as 
        initially promulgated under section 2 of the Nurse and Health 
        Care Worker Protection Act of 2009)'' before the period at the 
        end; and
            (2) in subsection (b)(4)--
                    (A) in subparagraph (A), inserting ``and the safe 
                patient handling, mobility, and injury prevention 
                standard'' after ``Bloodborne Pathogens standard''; and
                    (B) in subparagraph (B), inserting ``or the safe 
                patient handling, mobility, and injury prevention 
                standard'' after ``Bloodborne Pathogens standard''.
    (b) Effective Date.--The amendments made by subsection (a) shall 
apply to health care facilities 1 year after date of issuance of the 
final safe patient handling, mobility, and injury prevention standard 
required under section 2.

SEC. 4. NONPREEMPTION.

    (a) Effect on Other Laws.--Nothing in this Act shall be construed 
to--
            (1) preempt any law, rule, or regulation of a State or 
        political subdivision of a State, unless such law, rule, or 
        regulation is in conflict with this Act or a regulation or 
        order issued under this Act; or
            (2) impair or diminish in any way the authority of any 
        State to enact and enforce any law which provides equivalent or 
        greater protections for employees engaging in conduct protected 
        under this Act.
    (b) Rights Retained by Health Care Workers.--Nothing in this Act 
shall be construed to diminish the rights, privileges, or remedies of 
any health care worker or employee under any Federal or State law, or 
under any collective bargaining agreement.

SEC. 5. DEFINITIONS.

    For purposes of this Act:
            (1) Direct-care registered nurse.--The term ``direct-care 
        registered nurse'' means an individual who has been granted a 
        license by at least one State to practice as a registered nurse 
        and who provides bedside care or outpatient services for one or 
        more patients or residents.
            (2) Employee.--The term ``employee'' means any individual 
        employed by a health care employer, to include health care 
        workers, as well as employees who do not qualify as health care 
        workers, including independent contractors.
            (3) Employment.--The term ``employment'' includes the 
        provision of services under a contract or other arrangement.
            (4) Handling.--The term ``handling'' includes actions such 
        as lifting, transferring, repositioning, mobilizing, moving, or 
        any other action involving the physical movement, manipulation, 
        or support of a patient by a health care worker, or any direct 
        patient care action which presents a risk of musculoskeletal 
        injury.
            (5) Health care employer.--The term ``health care 
        employer'' means an outpatient health care facility, hospital, 
        nursing home, home health care agency, social assistance 
        facility or program, hospice, federally qualified health 
        center, nurse managed health center, rural health clinic, or 
        any similar health care facility that employs direct-care 
        registered nurses or other health care workers.
            (6) Health care worker.--The term ``health care worker'' 
        means an individual who has been assigned by a health care 
        employer to engage in patient handling, including direct-care 
        registered nurses, independent contractors, or individuals who 
        perform the duties of health care workers.
            (7) Lift team.--The term ``lift team'' means health care 
        workers with specialized training and knowledge of safe patient 
        handling, mobility, and injury prevention practices and 
        technology.
                                 <all>